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Laser surgery for early melanoma?
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Laser surgery for early melanoma?

› Forums › General Melanoma Community › Laser surgery for early melanoma?

  • Post
    • October 2, 2017 at 4:46 pm
    barry_g
    Participant

      I'd appreciate any information on whether a viable option exists to surgical excision of facial melanoma in situ.  Is laser surgery an option?  I'm a bit freaked out by the prospect of facial scarring, even when a plastic surgeon performs the excision.

      Thanks

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    • Replies
        • October 2, 2017 at 5:01 pm
        Jamie1960
        Participant

          Depending on the diagnosis / staging, you may be able to opt for Mohs surgery versus wide excision.

          Whatever the procedure, those on this board will quickly tell you that some scarring is preferable to the alternative.

          A good surgeon will be able to minimize the scarring, irrespective of the procedure; I now have four incisions ranging in length from 3" to 5" and, with one exception (arm / elbow with mitosis, regression and ulceration present) all have, remarkably, healed to resemble little more than a pencil-line width discoloration.

          In the right hands, you will be fine.

            • October 2, 2017 at 5:14 pm
            barry_g
            Participant

              Thanks!  The facial location is of major concern.

              • October 3, 2017 at 12:22 am
              barry_g
              Participant

                I've been searching on the Web and from what I can tell, it appears that there are a select few doctors now performing Mohs surgery for melanoma in situ and that it's a fairly recent advancement. Here's an example of what I found: http://scopeblog.stanford.edu/2016/06/24/in-situ-melanoma-patients-now-eligible-for-quicker-procedure-at-stanford-medicine/

                Do I have this right? This would seem a desirable option over blind 5mm margin excision, even if I had to travel for the surgery.  But I'm not sure these doctors are going to be easy to find.

                • October 3, 2017 at 2:42 am
                jennunicorn
                Participant

                  Yes I have known multiple people to get Mohs for melanoma in situ on the face. You just have to find a dermatologist that regularly performs Mohs.

                  • October 3, 2017 at 1:26 pm
                  Janner
                  Participant

                    Mohs surgeons are certified.  You can find someone certified in Mohs surgery.  I believe the college of Mohs lists certified individuals.  My Mohs surgeon will do Mohs for Lentigo Maligna – a specific type of in situ.  Not typically for superficial spreading.  Lentigo Maligna has a high local recurrence rate. 

                  • October 6, 2017 at 3:58 pm
                  jenny22
                  Participant

                    I just had some experience with this same subject, though not for me, but for my Mom……in June she had a biopsy done for something on her neck…it came back as Melanoma…not in situ…..but very small…The reccommendation from her Derm was to have MOHS…I was very suspect, as i know the usual protocol was WLE with 1 cm margins…..after much research, and even a consult with my own Melanoma ONC, who is melanoma sepcailaist (anna pavlick at NYU) we proceeded with the MOHS….after confiring that though it would be MOHS they would still take the necessary margins.

                    Apparently only certain facliities have the staining necessary to do MOHS for melanoma…she had hers done at Univ of Penn where they have have done lots of studies and now beleive for certain Melanoma MOHS with the right staining has had great  results and fewer local recurrences.

                    Not sure where you are located, but you may be fine with MOHs, esp for in situ!!!!!

                    Best of luck,

                    jenny

                      • October 11, 2017 at 12:21 pm
                      barry_g
                      Participant

                        Update:

                        Based on a highly respected recommendation, I traveled to Cambridge MA and had an excision with 5mm margins and reconstruction done by Dr. Stephen Sullivan. Melanoma excision with reconstruction is a specialty of Dr. Sullivan and he has done specific work/research with Dr. Frank Isik in Seattle (both are plastic surgeons) on exactly this. I highly recommend both these doctors. My procedure was done under local anesthetic only (by my request) and I was impressed with the degree of care Dr. Sullivan exercised during all phases of the procedure, and particularly during the reconstruction (fitting with my facial contours, suturing in such a way that the scar would be minimal and flat, etc etc)

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